1
|
Chiang CT, Yang RC, Kao YC, Wu RC, Ouyang CS, Lin LC. Connectivity Disturbances in Self-Limited Epilepsy with Centrotemporal Spikes: A Partial Directed Coherence Analysis of Electroencephalogram. Clin EEG Neurosci 2024; 55:257-264. [PMID: 37229662 DOI: 10.1177/15500594231177979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Although the remission of self-limited epilepsy with centrotemporal spikes (SeLECTS) usually occurs by adolescence, deficits in cognition and behavior are not uncommon. Several functional magnetic resonance imaging (fMRI) studies have revealed connectivity disturbances in patients with SeLECTS associated with cognitive impairment. However, the disadvantages of fMRI are expensive, time-consuming, and motion sensitive. In the current study, we used a partial directed coherence (PDC) method to analyze electroencephalogram (EEG) for exploring brain connectivity in patients with SeLECTS. This study enrolled 38 participants (19 patients with SeLECTS and 19 healthy controls) for PDC analysis. Our results demonstrated that the controls had significantly higher PDC inflow connectivity in the F7, T3, FP1, and F8 channels than patients with SeLECTS. By contrast, the patients with SeLECTS demonstrated significantly higher PDC inflow connectivity than did the controls in the T5, Pz, and P4 channels. We also compared the PDC connectivity in different Brodmann areas between the patients with SeLECTS and the controls. The results revealed that the inflow connectivity in the BA9_46_L area was significantly higher in the controls than in the patients with SeLECTS, whereas the inflow connectivity in the MIF_L area 4 was significantly higher in the patients with SeLECTS than in the controls. Our proposed approach of combining EEG with PDC provides a convenient and useful tool for investigating functional connectivity in patients with SeLECTS. This approach is time-saving and inexpensive compared with fMRI, but it achieves similar results to fMRI.
Collapse
Affiliation(s)
- Ching-Tai Chiang
- Department of Computer and Communication, National Pingtung University, Pingtung, Taiwan (R.O.C.)
| | - Rei-Cheng Yang
- Departments of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan (R.O.C.)
| | - Yu-Chia Kao
- Departments of Pediatrics, E-Da Hospital, Kaohsiung, Taiwan (R.O.C.), Taiwan (R.O.C.)
| | - Rong-Ching Wu
- Department of Electrical Engineering, I-Shou University, Kaohsiung, Taiwan (R.O.C.)
| | - Chen-Sen Ouyang
- Department of Information Management, National Kaohsiung University of Science and Technology, Kaohsiung, Taiwan (R.O.C.)
| | - Lung-Chang Lin
- Departments of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan (R.O.C.)
- Department of Pediatrics, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan (R.O.C)
| |
Collapse
|
3
|
Ofer I, Jacobs J, Jaiser N, Akin B, Hennig J, Schulze-Bonhage A, LeVan P. Cognitive and behavioral comorbidities in Rolandic epilepsy and their relation with default mode network's functional connectivity and organization. Epilepsy Behav 2018; 78:179-186. [PMID: 29103838 DOI: 10.1016/j.yebeh.2017.10.013] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Revised: 04/27/2017] [Accepted: 10/13/2017] [Indexed: 01/18/2023]
Abstract
OBJECTIVE Rolandic epilepsy (RE) is characterized by typical interictal-electroencephalogram (EEG) patterns mainly localized in centrotemporal and parietooccipital areas. An aberrant intrinsic organization of the default mode network (DMN) due to repeated disturbances from spike-generating areas may be able to account for specific cognitive deficits and behavioral problems in RE. The aim of the present study was to investigate cognitive development (CD) and socioemotional development (SED) in patients with RE during active disease in relation to DMN connectivity and network topology. METHODS In 10 children with RE and active EEG, CD was assessed using the Wechsler Intelligence Scale for Children-IV (WISC-IV); SED was assessed using the Fünf-Faktoren-Fragebogen für Kinder (FFFK), a Big-Five inventory for the assessment of personality traits in children. Functional connectivity (FC) in the DMN was determined from a 15-minute resting state functional magnetic resonance imaging (fMRI), and network properties were calculated using standard graph-theoretical measures. RESULTS More severe deficits of verbal abilities tended to be associated with an earlier age at epilepsy onset, but were not directly related to the number of seizures and disease duration. Nonetheless, at the network level, disease duration was associated with alterations of the efficiency and centrality of parietal network nodes and midline structures. Particularly, centrality of the left inferior parietal lobe (IPL) was found to be linked with CD. Reduced centrality of the left IPL and alterations supporting a rather segregated processing within DMN's subsystems was associated with a more favorable CD. A more complicated SED was associated with high seizure frequency and long disease duration, and revealed links with a less favorable CD. SIGNIFICANCE An impaired CD and - because of their interrelation - SED might be mediated by a common pathomechanism reflected in an aberrant organization, and thus, a potential functional deficit of the DMN. A functional segregation of (left) parietal network nodes from the DMN and a rather segregated processing mode within the DMN might have positive implications/protective value for CD in patients with RE.
Collapse
Affiliation(s)
- Isabell Ofer
- Epilepsy Center, Medical Center - University of Freiburg, Germany; Faculty of Medicine, University of Freiburg, Germany.
| | - Julia Jacobs
- Epilepsy Center, Medical Center - University of Freiburg, Germany; Faculty of Medicine, University of Freiburg, Germany; Clinic for neuropediatrics and muscular diseases, Medical Center - University of Freiburg, Germany
| | - Nathalie Jaiser
- Faculty of Medicine, University of Freiburg, Germany; Clinic for neuropediatrics and muscular diseases, Medical Center - University of Freiburg, Germany
| | - Burak Akin
- Faculty of Medicine, University of Freiburg, Germany; Clinic for Radiology, Medical Physics, Medical Center - University of Freiburg, Germany
| | - Jürgen Hennig
- Faculty of Medicine, University of Freiburg, Germany; Clinic for Radiology, Medical Physics, Medical Center - University of Freiburg, Germany
| | - Andreas Schulze-Bonhage
- Epilepsy Center, Medical Center - University of Freiburg, Germany; Faculty of Medicine, University of Freiburg, Germany
| | - Pierre LeVan
- Faculty of Medicine, University of Freiburg, Germany; Clinic for Radiology, Medical Physics, Medical Center - University of Freiburg, Germany
| |
Collapse
|
4
|
Dörtcan N, Tekin Guveli B, Dervent A. Long-Term Clinical and Electroencephalography (EEG) Consequences of Idiopathic Partial Epilepsies. Med Sci Monit 2016; 22:1480-5. [PMID: 27138132 PMCID: PMC4917323 DOI: 10.12659/msm.898626] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background Idiopathic partial epilepsies of childhood (IPE) affect a considerable proportion of children. Three main electroclinical syndromes of IPE are the Benign Childhood Epilepsy with Centro-temporal Spikes (BECTS), Panayiotopoulos Syndrome (PS), and Childhood Epilepsy with Occipital Paroxysms (CEOP). In this study we investigated the long-term prognosis of patients with IPE and discussed the semiological and electroencephalography (EEG) data in terms of syndromic characteristics. Material/Methods This study included a group of consecutive patients with IPE who had been followed since 1990. Demographic and clinical variables were investigated. Patients were divided into 3 groups – A: Cases suitable for a single IPE (BECTS, PS and CEOP); B: cases with intermediate characteristics within IPEs; and C: cases with both IPE and IGE characteristics. Long-term data regarding the individual seizure types and EEG findings were re-evaluated. Results A total of 61 patients were included in the study. Mean follow-up duration was 7.8±4.50 years. The mean age at onset of seizures was 7.7 years. There were 40 patients in group A 40, 14 in group B, and 7 in group C. Seizure and EEG characteristics were also explored independently from the syndromic approach. Incidence of autonomic seizures is considerably high at 2–5 years and incidence of oromotor seizures is high at age 9–11 years. The EEG is most abnormal at 6–8 years. The vast majority (86%) of epileptic activity (EA) with parietooccipital is present at 2–5 years, whereas EA with fronto-temporal or multiple sites become more abundant between ages 6 and 11. Conclusions Results of the present study provide support for the age-related characteristics of the seizures and EEGs in IPE syndromes. Acknowledgement of those phenomena may improve the management of IPEs and give a better estimate of the future consequences.
Collapse
Affiliation(s)
- Nimet Dörtcan
- Department of Neurology and Neurophysiology, Fatih Sultan Mehmet Training and Research Hospital, İstanbul, Turkey
| | - Betul Tekin Guveli
- Department of Neurology, Bakırkoy Psychiatric and Neurological Diseases Training and Research Hospital, İstanbul, Turkey
| | - Aysin Dervent
- Department of Child Neurology, Special Child Neurology Clinic, İstanbul, Turkey
| |
Collapse
|
5
|
Meletti S, Ruggieri A, Avanzini P, Caramaschi E, Filippini M, Bergonzini P, Monti G, Vignoli A, Olivotto S, Mastrangelo M, Santucci M, Gobbi G, Veggiotti P, Vaudano AE. Extrastriate visual cortex in idiopathic occipital epilepsies: The contribution of retinotopic areas to spike generation. Epilepsia 2016; 57:896-906. [PMID: 27093945 DOI: 10.1111/epi.13385] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2016] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To provide insight into the pathophysiology of idiopathic childhood occipital epilepsies (ICOEs), by mapping the contribution of retinotopic visual areas to the generation and sustainment of epileptic activity. METHODS Thirteen patients affected by ICOEs (mean age = 10.9 years) underwent a video electroencephalography-functional magnetic resonance imaging (EEG-fMRI) study. A flexible-related fMRI analysis was applied to estimate the shape of the blood oxygen level-dependent (BOLD) response in each patient. Second-level analysis was performed using the interictal EEG discharge (IED)-specific response shape for the ICOE group. The resulting fMRI t-maps were warped to the Population-Average, Landmark- and Surface-based (PALS)-B12 atlas in Caret. For localization purposes, functional results were plotted and compared against 19 retinotopic areas for each hemisphere. A correlation analysis was performed between the hemodynamic maps and electroclinical variables. RESULTS The shape of the group-averaged hemodynamic response in ICOE patients showed an earlier time-to-peak and a more pronounced undershoot than the canonical hemodynamic response function (HRF). The random-effect analysis showed positive hemodynamic changes in the bilateral temporooccipital network. With regard to the retinotopic subdivision of the visual cortex, the primary visual area was consistently spared. Conversely, an extensive involvement of the occipitotemporal cortex, including the fusiform gyrus, and the occipitoparietal areas was observed. Moreover, a linear relationship was detected between the occipital spike-density and BOLD increases at the postcentral gyrus and temporooccipital cortex. SIGNIFICANCE Our data indicate that both the ventral and dorsal visual pathways are involved in spike generation in ICOEs, to extents that vary between patients, and reinforce the concept of benign childhood seizure susceptibility syndrome as a substrate for ICOEs. Finally, these results underscore the need for appropriate neuropsychological testing in these children, aimed at revealing selective impairments in functions subserved by both visual pathways.
Collapse
Affiliation(s)
- Stefano Meletti
- Department of Biomedical, Metabolic, and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.,Neurology Unit, NOCSAE Hospital, AUSL Modena, Modena, Italy
| | - Andrea Ruggieri
- Department of Biomedical, Metabolic, and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Pietro Avanzini
- Department of Neuroscience, University of Parma, Parma, Italy
| | | | - Melissa Filippini
- Child Neuropsychiatry Unit, IRCCS, Institute of Neurological Sciences, Bellaria Hospital, Bologna, Italy
| | | | - Giulia Monti
- Department of Biomedical, Metabolic, and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.,Neurology Unit, NOCSAE Hospital, AUSL Modena, Modena, Italy
| | - Aglaia Vignoli
- Department of Health Sciences, University of Milano, Milano, Italy
| | - Sara Olivotto
- Brain and Behavior Department, University of Pavia, Pavia, Italy
| | | | - Margherita Santucci
- IRCCS Institute of Neurological Sciences, Bellaria Hospital, AUSL of Bologna, Bologna, Italy.,Department of Biomedical and Neuromotor Science, University of Bologna, Bologna, Italy
| | - Giuseppe Gobbi
- Child Neuropsychiatry Unit, IRCCS, Institute of Neurological Sciences, Bellaria Hospital, Bologna, Italy
| | - Pierangelo Veggiotti
- Brain and Behavior Department, University of Pavia, Pavia, Italy.,Department of Child Neurology and Psychiatry C. Mondino, National Neurological Institute, University of Pavia, Pavia, Italy
| | - Anna Elisabetta Vaudano
- Department of Biomedical, Metabolic, and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.,Neurology Unit, NOCSAE Hospital, AUSL Modena, Modena, Italy
| |
Collapse
|
6
|
Lopes R, Simões MR, Leal AJR. Neuropsychological abnormalities in children with the Panayiotopoulos syndrome point to parietal lobe dysfunction. Epilepsy Behav 2014; 31:50-5. [PMID: 24351962 DOI: 10.1016/j.yebeh.2013.11.013] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2013] [Revised: 11/08/2013] [Accepted: 11/12/2013] [Indexed: 11/18/2022]
Abstract
Panayiotopoulos syndrome (PS) is a common epilepsy syndrome associated with rare clinical seizures and unknown localization of the epileptogenic area. Despite findings of normal development in patients with PS, recent neuropsychological studies point to subtle and diverse cognitive impairments. No well-outlined hypothesis about the localization of the brain dysfunction responsible for these impairments has been proposed. We further explored the cognitive dysfunctions in PS and made inferences on the most likely anatomical localization of brain impairment. A group of 19 patients (aged 6-12) with PS was rated according to spike activity and lateralization. The patients were submitted to a neuropsychological evaluation to assess general intelligence, memory, language, visual-perceptual abilities, attention, and executive functions. Using 35-channel scalp EEG recordings, the N170 face-evoked event-related potential (ERP) was obtained to assess the functional integrity of the ventral pathway. All patients with PS showed normal IQ but subtle and consistent neurocognitive impairments. Namely, we found abnormalities in the copy task of the Rey-Osterrieth Complex Figure and in the Narrative Memory Test. There was no correlation between neuropsychological impairments with spike activity and hemispheric spike lateralization. The N170 ERP was normal in all patients except for one. Our neuropsychological findings demonstrate impairments in visual-perceptual abilities and in semantic processing. These findings, paired with the absence of occipital lobe dysfunction in all neuropsychological studies of PS performed to this date, support the existence of parietal lobe dysfunction.
Collapse
Affiliation(s)
- Ricardo Lopes
- Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal.
| | - Mário R Simões
- Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
| | - Alberto J R Leal
- Instituto Universitário de Lisboa (ISCTE-IUL), Cis-IUL, Lisboa, Portugal; Department of Neurophysiology, Centro Hospitalar Psiquiatrico de Lisboa, Lisbon, Portugal; Department of Pediatric Neurology, Centro Hospitalar Lisboa Central, Portugal
| |
Collapse
|